Clinical Characteristics of Acute Upper Gastrointestinal Bleeding in a Tertiary Referral Center / 대한소화기학회지

BACKGROUND/AIMS: Acute upper gastrointestinal bleeding (UGIB) is still responsible for significant morbidity in spite of various therapeutic advances. The aims of this study were to evaluate the success rate in managing UGIB and predicting factors that affected clinical courses. METHODS: From August 2003 to April 2005, medical data (registered in a standard database categories) of 318 patients who underwent endoscopic examination to evaluate UGIB were analyzed. Early and final treatment success rates were evaluated on the next day and 14 days after the initial endoscopic procedures respectively (or the day of discharge). RESULTS: Main causes of UGIB were peptic ulcer (50.9%), varices (28.3%), Mallory-Weiss syndrome (10.3%). Endoscopic treatments were tried in 200 patients (63.0%). Number of patients who underwent operation and deaths were 4 (1.3%) and 13 (4.1%), respectively. Early and final success rates were 86.2% and 94.0%. Independent prognostic factors related with early success rates were volume of transfusion (OR 0.80, 95% CI 0.72-0.89, p<0.001) and bleeding during the ventilator care (OR 0.03, 95% CI 0.01-0.31, p<0.001), whereas those factors related with final success rates were volume of transfusion (OR 0.79, 95% CI 0.69-0.90, p<0.001), bleeding during the stay in intensive care unit (ICU) (OR 0.12, 95% CI 0.13-0.49, p<0.001). CONCLUSIONS: Early and final success rates of bleeding control were 86.2% and 94.0% in acute UGIB. Volume of transfusion, bleeding during ICU state or ventilator state were important predictive factors of the treatment failure.

A Case of Mallory-Weiss Syndrome Complicating Pregnancy in a Patient with Scleroderma

The majority of patients with scleroderma have gastrointestinal involvement, and a few experience gastrointestinal hemorrhage, however, gastrointestinal hemorrhage due to Mallory-Weiss syndrome is very rare. We report upon a 24-year-old pregnant woman with scleroderma who had gastrointestinal hemorrhage due to Mallory-Weiss syndrome.

Síndrome de Mallory-Weiss / Mallory-Weiss syndrome

Fueron estudiados treinta y tres pacientes diagnosticados como síndrome de Mallory-Weiss. Los síntomas más frecuentes fueron vómitos (90%) y hematemesis (84%). Se encontró el antecedente de ingesta alcohólica reciente en 39%de los pacientes; el diagnóstico se efectuó endoscópicamente en todos ellos; 5 casos presentaron hemorragia masiva (15%). El tratamiento médico fue exitoso en 32 pacientes. Un paciente falleció por complicación operatoria, lo que le otorga a nuestra casuística una mortalidad de 3%. Creemos que el síndrome de Mallory-Weiss, es una patología que puede ser manejada médicamente en la mayoría de los casos. Si fuese necesario el tratamiento quirúrgico, se recomienda la sutura simple de las laceraciones mucosas

Síndrome de mallory-weiss: revisäo de 130 casos do Centro de Hemorragia Digestiva do Hospital do Andaraí

Os autores fizeram uma revisäo de 130 paciente internados no C.H.D. do Hospital do Andaraí, portadores de Síndrome de Mallory-Weiss, comparando sua experiência com a da literatura internacional

Laceraçäo da mucosa cardioesofagiana: experiência de sete anos / Laceration of cardio-oesophageal mucosa: a 7-year experience

O diagnóstico da LMCE é fundamentalmente endoscópico, devido à inespecificidade da história e do quadro clínico que a acompanham. Entre os 61 casos por nós estudados, apenas 40 (65%) resultaram, com certeza, em hemorragia digestiva. Quinze outros foram observados casualmente em endoscopias eletivas (nove) ou de urgência (seis), quando coexistiam com outra lesäo responsável pelo sangramento. Há ainda seis outros casos também diagnosticados em endoscopia de urgência, nos quais näo se chegou à conclusäo da fonte da HDAA. A evoluçäo da LMCE tende a ser benigna, mesmo quando acompanhada de sangramento digestivo, nos pacientes previamente hígidos, porém a mortalidade foi elevada (14,3%) naqueles com outras patologias associadas